J38.02: Paralysis of vocal cords and larynx, bilateral
J38.02, paralysis of vocal cords and larynx, bilateral, is listed as a covered diagnosis in 15 Medicare billing and coding articles that apply to 12 HCPCS Level II codes, including J0585 (Injection, onabotulinumtoxina, 1 unit), J0588 (Injection, incobotulinumtoxin a, 1 unit), J0586 (Injection, abobotulinumtoxina, 5 units). The articles come from 5 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with J38.02 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0585 | Injection, onabotulinumtoxina, 1 unit | Special coverage instructions apply | — | 6 |
| J0588 | Injection, incobotulinumtoxin a, 1 unit | Carrier judgment | — | 6 |
| J0586 | Injection, abobotulinumtoxina, 5 units | Carrier judgment | — | 6 |
| J0587 | Injection, rimabotulinumtoxinb, 100 units | Special coverage instructions apply | — | 6 |
| J0589 | Injection, daxibotulinumtoxina-lanm, 1 unit | Carrier judgment | — | 6 |
| G0451 | Development testing, with interpretation and report, per standardized instrument form | Carrier judgment | — | 1 |
| G0238 | Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring) | Carrier judgment | — | 2 |
| G0237 | Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring) | Carrier judgment | — | 2 |
| G0239 | Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring) | Carrier judgment | — | 2 |
| G0153 | Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0161 | Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G0255 | Current perception threshold/sensory nerve conduction test, (snct) per limb, any nerve | Non-covered by Medicare | Not covered | 5 |
Medicare policy articles listing J38.02
- A52866: Billing and Coding: Speech-Language Pathology (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33580, L34046
- A53052: Billing and Coding: Home Health Speech-Language Pathology (Palmetto GBA (HHH MAC); 2 Level II codes). LCD with the same title: L34563
- A57185: Billing and Coding: Botulinum Toxin Injections (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35170, L35172, L39832, L39836
- A57186: Billing and Coding: Botulinum Toxin Injections (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35170, L35172, L39832, L39836
- A59707: Billing and Coding: Botulinum Toxin Injections (Wellpoint Federal (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35170, L35172, L39832, L39836
- A59714: Billing and Coding: Botulinum Toxin Injections (Palmetto GBA (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35170, L35172, L39832, L39836
- A59726: Billing and Coding: Botulinum Toxins Injections (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 5 Level II codes)
- A59809: Billing and Coding: Botulinum Toxin Injections (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L35170, L35172, L39832, L39836
- A56717: Billing and Coding: Respiratory Therapy (Respiratory Care) (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34430
- A57224: Billing and Coding: Respiratory Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L34149
- A57307: Billing and Coding: Nerve Conduction Studies and Electromyography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57478: Billing and Coding: Nerve Conduction Studies and Electromyography (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A54969: Billing and Coding: Nerve Conduction Studies and Electromyography (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A57668: Billing and Coding: Nerve Conduction Studies and Electromyography (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
- A56619: Billing and Coding: Nerve Conduction Studies and Electromyography (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34594, L34859, L35048, L35081
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other J38 diagnoses (Diseases of vocal cords and larynx, not elsewhere classified)
- J38.01 — Paralysis of vocal cords and larynx, unilateral
- J38.5 — Laryngeal spasm
- J38.7 — Other diseases of larynx
Frequently asked questions
Does Medicare cover J38.02 (Paralysis of vocal cords and larynx, bilateral)?
Medicare covers items and services, not diagnoses. 15 Medicare billing and coding articles list J38.02 as a covered diagnosis for 12 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 J38.02?
The Level II codes from the policies most specific to this diagnosis are J0585 (Injection, onabotulinumtoxina, 1 unit, 6 articles); J0588 (Injection, incobotulinumtoxin a, 1 unit, 6 articles); J0586 (Injection, abobotulinumtoxina, 5 units, 6 articles); J0587 (Injection, rimabotulinumtoxinb, 100 units, 6 articles); J0589 (Injection, daxibotulinumtoxina-lanm, 1 unit, 6 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list J38.02?
A52866 (Billing and Coding: Speech-Language Pathology); A53052 (Billing and Coding: Home Health Speech-Language Pathology); A57185 (Billing and Coding: Botulinum Toxin Injections), and 12 more articles.
What is ICD-10-CM code J38.02?
J38.02 is the ICD-10-CM code for paralysis of vocal cords and larynx, bilateral, in category J38 (Diseases of vocal cords and larynx, not elsewhere classified), chapter 10: Diseases of the respiratory system.
Next steps
- Run a reimbursement report for a device billed under J0585
- Watch J0585 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0585
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 10: Diseases of the respiratory system · All diagnoses · HCPCS lookup